Eslicarbazepine Use During Breastfeeding: A Case Report

Eslicarbazepine acetate is an anti-seizure medication. Only very few data are available regarding its use during lactation, and women treated with eslicarbazepine acetate for drug resistant epilepsy would sometimes give up with breastfeeding.

We report on the successful outcome of two successive infants breastfed by a mother treated with eslicarbazepine acetate for pharmacoresistant epilepsy.

To evaluate the exposure to eslicarbazepine acetate through maternal milk, the infants' serum levels have been measured. The infant serum concentrations of eslicarbazepine were 1.8 mg/L at 14 days of life (i.e., 9.1% of the maternal serum concentration) for the first child and 1.5 mg/L at 18 days of life for the second child. No adverse drug reactions were reported in either infant after 13 months of breastfeeding for each infant.

Although no previous data on the use of eslicarbazepine acetate during lactation are available, limited but reassuring data have been reported with oxcarbazepine, of which eslicarbazepine is a major metabolite. Given the well-known benefits of breastfeeding, and according to the above reassuring data, breastfeeding under clinical supervision could be considered for healthy full-term infants of mothers on eslicarbazepine acetate monotherapy. However, parents should be warned that data concerning the safety of eslicarbazepine during breastfeeding are scarce, and long-term neurodevelopment outcomes in breastfed children are unknown. Additionally, the infants' serum levels should be measured in case of an unexplained adverse reaction.